Best Anti-Inflammatory Medication

Which Nonsteroidal Anti-Inflammatory Medication Is Best?

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Many patients are prescribed nonsteroidal anti-inflammatory medications (often called NSAIDs) for a variety of common orthopedic conditions including arthritis, tendonitis, and bursitis. These medications are particularly useful not only because they help decrease pain, but they also help control swelling and inflammation.

However, as with any medication, there are both risks and benefits, and people should be careful before turning to a bottle to address their symptoms.

While a medication can be a safe and effective treatment for these orthopedic conditions, there may be safe alternatives to a medication. Before beginning any medication, discuss the pros and cons with your doctor, and always be sure your primary physician is aware of any new medication you are taking, especially if you are taking it regularly.

Prescription NSAIDs Better?

NSAIDs are available both over-the-counter and as a prescription medication. It is very important to understand that while there are differences between prescription and non-prescription NSAIDs, this difference is not the potential relief of symptoms. Many patients find their best response from over-the-counter NSAIDs.

There has been no study showing that newer NSAIDs (the so-called COX-2 inhibitors), prescription NSAIDs, or more expensive NSAIDs, treat pain or swelling any better than more traditional NSAID medications. Most of the research evaluating the effects of NSAIDs has been done using over-the-counter ibuprofen.

Which to Take?

Often patients will experience a different response in treatment with a different medication. This could be why some medications have helped your symptoms while others do not have a significant effect. This is not unusual, and it is difficult to predict which medications will most benefit a given individual.

The best way to determine which NSAID is best for you is to try different options. Often a physician will recommend one NSAID, and if adequate relief of symptoms is not obtained within several weeks of treatment, another NSAID can be tried.

One of the best reasons to consider some of the newer, prescription medications, such as Celebrex or Mobic, is that these may be taken as once-a-day doses rather than three or four times daily. In addition, the COX-2 inhibitors are thought to have fewer side-effects on the stomach. Because of the possible decreased risk of stomach problems, may doctors will recommend the COX-2 inhibitors for patients who may have risk factors for bleeding or stomach ulcers.

Most Common NSAIDs

Names of medications to be confusing, and physicians and other healthcare professionals often use generic and brand names interchangeably. Here is a list of some of the most commonly prescribed NSAID medications:

  • Aspirin (brand names include Bayer, Ecotrin, Bufferin)
  • Ibuprofen (Motrin, Advil)
  • Naproxen (Aleve, Naprosyn)
  • Meloxicam (Mobic)
  • Celecoxib (Celebrex)
  • Indomethacin (Indocin)

How Else To Control Inflammation

Medications are not the only solution to control inflammation and discomfort.

As we become increasingly aware and sensitive the possible side-effects of any medication, more patients and doctors alike are interested in non-pharmacologic methods to control inflammation. There are many ways that people address inflammation. Some have better scientific support than others, but most all are safe to try.

A good place to start is with R.I.C.E. treatment of inflammation, which stands for: rest, ice, compression, and elevation. Other treatments which may be helpful include the foods and supplements you ingest, topical treatments to the painful area, and the activities we perform.

The most often neglected method to control inflammation that I see in my patients is rest. Not only does this mean resting from athletics, but often this means allowing an injured body part to rest from normal activities which may prolong inflammation. We live busy lives that may not allow for rest, but ignoring the signs of inflammation may prolong the problem. Therefore, look for ways to rest your injured body part to allow the inflammation to subside and the recovery process to unfold.

Side Effects of NSAIDs

NSAID medications have potential side effects, even though many of these medications can be obtained over-the-counter. Some of the side effects are minor, other certainly worrisome. Some people may be more prone to side effects given other medical conditions. For that reason, NSAID medication should be used with caution. If there is ever a question of whether or not it is safe for you to take these medications, and you should discuss this with your doctor. Anyone taking NSAID medications for more than a few days should have a discussion with her physician about the potential for side effects.

Some of the more common side effects of NSAID medications include:

Stomach upset/ulcers: Some people are prone to gastrointestinal upset and the development of stomach ulcers as a result of taking these medications. People with a history of stomach ulcers need to use NSAID medications with extreme caution and always under the supervision of their physician.

Hypertension/stroke: The use of NSAID medications, especially for routine, longer term use, has been shown to increase the risk of hypertension and stroke. People who have increased risk of these conditions should discuss NSAID use with their physician.

Bleeding risk: Certain NSAID medications can cause increased risk of bleeding. Most people can tolerate this, but people who have upcoming surgical procedures or are on other blood thinning medications may not be able to take NSAID medications.

Kidney problems: People with underlying kidney conditions may not be able to take NSAID medications, even in very low doses for short time. 

While these are not the only risks NSAID medications, they are somewhat more common, and some of the more worrisome, side effects. It is always safest to have a discussion with your physician if you have any concerns about the risk of taking these medications. It is important to understand that even in healthy people without underlying medical conditions, there is always the risk associated with any medication. The benefits of taking an anti-inflammatory medication need to be balanced with the possible risks of taking the medication.

A Word From Verywell

Nonsteroidal anti-inflammatory medications are one of the most commonly used types of medications for musculoskeletal conditions. NSAIDs can be effective for a wide variety of orthopedic conditions from arthritis, tendinitis, or other inflammatory conditions. Determining the best NSAID for your condition may depend on a number of different factors, and what works well for one individual may not be the best medication for another. There are possible side effects of different NSAID medications the patient should be aware of, and you should discuss with your physician if taking these medications for more than a short period of time.

Sources:

Solomon DH, et al. "Nonsteroidal antiinflammatory drugs (NSAIDs) (Beyond the Basics)" UpToDate. Jul 24, 2017.